Intraoperative and postoperative arterial ruptures associated with 657 iliac artery balloon dilatation procedures in our department from 1981 to 2000 were prospectively collected and retrospectively analyzed. Our results showed that failure to exercise basic safety principles and the presence of heavily calcified plaque are the major predictors of iliac artery rupture during balloon dilatation. If rupture is contained, surveillance alone is unreliable. Optimal treatment requires temporary hemostasis by balloon tamponade followed by placement of a covered stent to occlude the opening.
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